We Interrupt This Blog To Bring You This Important Health Care Bulletin: It’s Just A Systems Thing

24Aug

The post originally scheduled for this time (“Put On Your Emotional Armor”) has been delayed so that engineering thinking can be applied to the current debate about health care reform.

Complex subjects such as health care can — and should — be reviewed and debated from various perspectives, including federalism, privacy, cost, freedom of choice, and others. But is there a way to avoid being overwhelmed by complexity? Oftentimes, yes. One of the most important tools of the engineer is called sensitivity analysis. This is simply a methodical way of separating the wheat from the chaff, or a way of detecting what is truly important and allowing trivial distractions to be dismissed.

For example, assume that you’re relaxing on a beach and are trying to optimize your comfort. You’ve picked a scenic spot with a breeze, you’ve adjusted the umbrella for just the right amount of shade while not spoiling the view, and you’ve brought along your favorite drink. As you take a sip, you gaze out idly at the blue-green sea, and —- no, it can’t be! Suddenly there is only one factor of importance affecting your comfort, and you make a frantic dash away from the shore to escape the inrushing monster tidal wave.

These dominant factors are the Big Gorilla variables. Compared to the Big Gorilla, all other factors are largely irrelevant, and one can simply focus on the Big Gorilla and see where it leads. From an engineering thinking perspective, the Big Gorilla variable in the health care debate is how well government performs as a system:

Assertion: The government is a better system for providing health care services to the public than the free market.

Assumption: “Government” is defined as a social system wherein power is centralized in the hands of a relatively small number of leaders who make decisions for the balance of the population. “Free Market” is defined as a social system wherein power is distributed broadly and evenly among the population.

Analysis:

If a social system is effective at providing health care services then there will be a tendency for good outcomes, regardless of the talent of those who work within the system.

If a social system is ineffective at providing health care services then there will be a tendency for poor outcomes, regardless of the talent of those who work within the system.

The governmental system has the following attributes: (Note: these attributes will be explained in more depth in future posts.)

Poor feedback (services provided are not significantly affected by whether or not the population wants or likes the services).

Slow response time (it responds very sluggishly, which can trigger instabilities that can create the opposite of the desired result).

Control is not distributed (its centralized organization makes it unreliable, inefficient, and prone to corruption).

The free market system has attributes that are the opposite of the governmental system.

Conclusion: The assertion is false. Government provision of health care services will be ineffective and therefore highly unsatisfactory compared to the free-market alternative.

Corollary: Improvement in health care services will be more effectively achieved with the government strictly avoiding any attempt to control the health care industry, and instead by providing a judicial framework that supports free-market principles (e.g. prevention of monopolies, elimination of laws that favor one company over another, reduction of barriers to free trade between the states, and streamlining judicial review rather than relying on regulatory micromanagement).

An important aspect of analysis is that it often allows results to be generalized. The above analysis leads to the following important general conclusion:

The Government Should be Used

To The Minimum Extent Possible For Providing Services

The above may seem counterintuitive since, after all, what is government for, if not for providing services? Nonetheless, an objective systems analysis indicates that the governmental system is vastly inferior to the alternative of free-market capitalism. This is not an ideological conclusion, nor is it a criticism of government workers. It is simply a fact that, regardless of the talent, integrity, intentions, and compassion of those in government, they will always be hobbled by an inefficient system. Plus some of these good folks will, over time, tend to become corrupt.

7 responses to “We Interrupt This Blog To Bring You This Important Health Care Bulletin: It’s Just A Systems Thing”

Jeannie Martin

August 27, 2009 at 12:52 am

Hi Ed,

I am enjoying your blog very much.

I realize you have scheduled topics, however I ask a favor. I’ve been watching the Glenn Beck show. He has been saying that he is a “Thinker”. Glenn and his staff have been researching the staff that Prez. O. has surrounded himself with. These people are a variety of communists, fascists and socialists that belief in eugenics, controlling free speech, particularly talk radio and also racist social policies akin to affirmative action to spread the wealth. Glenn states that these people have infiltrated the White House and are responsible for writing the health care bill, stimulus bill and cap and trade. I request that you use your principals to either debunk Glenn Beck as a guy who is genius at instigating fear to promote ratings, or if his research is valid we all need to warn everyone and take action. I have never been so afraid of a Pres. Admin. in my entire life.

I don’t know if you listen Glenn’s radio show or watch him on Fox news. I tend to believe he is giving this information as an act of service to our Country because I’ve listen to his radio show for many years and back then it was just funny.

You’ve raised an important general topic that is on my planned list: who do you trust?

In an engineering context, engineers and scientists are continually presented with a variety of information that is offered to resolve various design challenges. Oftentimes some of the data is quite complex, and a manager must make a decision based on inputs from experts who may have significant disagreements. Who should the manger trust? Extending this concept to how we manage our lives, what are the guidelines for deciding who we should trust? I will review all of this in a future post, but for now — using the Big Gorilla concept introduced in the last post — the biggies are (1) character, and (2) competence.

A person with good character will present independently verifiable data and will not object to having opinions questioned. A person of poor character will provide vague and emotionally-laden opinions that cannot be independently checked, and will attack persons who disagree rather than debate the specifics of the issue.

A competent person will provide well-researched data and reasoned analyses; a person of less competence will not be able to provide the supporting data or analyses to support their opinions.

Regarding the Glenn Beck show specifically, I have seen the show and find it to be quite interesting and provocative. One of the attributes that suggests that Beck is being straightforward is that he backs up his commentary with testable data; i.e. specific representations that can be independently verified. Sometimes he presents videos or audios, so the audience can directly view or hear the evidence themselves.

I think you have addressed some issues that are of vital importance to our nation. However, in keeping within the constraints I have established for this blog, my role is not to be Mr. Answer Man, but rather to be Mr. Toolkit Man, to present engineering thinking principles and some examples, so that readers may learn useful methods for evaluating important issues. Hopefully the above will be of a little help in evaluating the Glenn Beck show. As mentioned, I will be providing additional tools later, but In the meantime — if you are so inclined — please feel free to provide your own Assertion (e.g. Glenn Beck Can (Cannot) Be Trusted), Assumptions, Analysis, and Conclusion, which I will be happy to post under your byline on this blog.

Thank you for your response. Using the criteria you outlined, I have the following observations.

No. 1 – Character. I agree that Glenn Beck presents independent verifiable data. However as a prelude to the data gathering process he always states that “his guts don’t feel right”. Then his staff does the research to back up the uneasy feelings. While I wholeheartedly agree with you that most of life’s situations require logical solutions to a probem, I disagree that emotionally-laden opinions that cannot be independently checked indicate poor character. I have personally experienced situations in which I or others I am close to heeded the warnings of the irrational gut and have avoided life and death peril. We all need to use both logic (90%) and emotion (10%). I warn that emotional responses should be followed only when that uneasy feeling screams at you and you just can’t shake it off. Then you should do the research, if possible, to either back up or dismiss the validity of your feelings.

As I watch Glenn Beck beg viewers to present him with data that proves he is wrong about his statements, I must agree that he is overall a person of strong moral character.

No. 2 Competence. Glenn Beck claims he is a “rodeo clown”. However, he is smart enough to surround himself with competent people to research and to challenge him. I guess that makes him intelligent enough to present the information his team has gathered.

Okay, so I trust him. Thank you for the tools. However, you must know that part of my analysis of Glenn Beck’s character includes the fact that he has stated that he will not hire an employee that his German Shepherd Victor does not like. 😉

You raise another issue with your statement, “… I disagree that emotionally-laden opinions that cannot be independently checked indicate poor character.” This is an example of how inexact definitions can lead to different conclusions. My mini-definition on character was in the context of someone using emotional manipulation to obtain what they want. This trait is common to crooks and hustlers who know that they don’t have facts or logic on their side. I’m sorry I did not make this context clear.

Also, as Barb notes in her comment, it seems that you may be referring to intuition, rather than raw emotion, in coming to some conclusions. (Intuition is scheduled to be addressed in a future post.) I do agree that intuition can be very valuable, but as you note it is not infallible and must be used with caution.

Finally, regarding the use of German Shepherds as detectors of good character, I would hope that this is true. Having such a dog present at the signing of every contract would eliminate a lot of fraud. 🙂

Barb here, Ed’s wife. Not that that influences my response in any way. 🙂

Regarding making decisions based on emotion: I agree with you and disagree at the same time. From personal experience, I have discovered that both in my personal life and my professional life that sometimes I “just know” that something isn’t right, and I usually end up being correct. At the time, the only thing apparently manifest is an odd feeling in my stomach, but later on after I’ve taken whatever action to protect myself, I realize that there were indeed things there that fit Ed’s thinking process. It’s just that I either thought about them so fast, or somehow unconsciously, that I do not recall actually “thinking” them. But in reality I did. I wonder if that might be the same for you; that when you examine your “emotionally” based actions, that they are actually derived from fact, and yet somehow you are unaware of the process.

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